Fibromyalgia and A Multi-modal Treatment Program

A multi-modal pain treatment program entails a combination of cognitive/behavioral techniques with physical therapy and pain medication reduction. This study measured both objective and subjective pain reactions to such a program in female fibromyalgia (FM) patients. The researchers tested the patients' pain threshold, tolerance, and pain reaction immediately following and six months after the treatment program.

The patients made significant progress on the psychological assessments and pain measures but not on the laboratory evaluations of pain measurements. One hundred percent of the patients showed an improvement in their feeling of control over the pain, and 54% an increase in positive coping skills immediately following the program. The group reported an improvement in physical function, general well being, and overall experienced pain. Since the self-reports of pain were reduced, the researchers conclude the patients gained some relief. Yet, these reports did not correlate to patient reports of symptoms:

"This study is unique in that it found statistically significant improvement in functioning without a correlating decrease in symptomology. These findings are also clinically significant; the treated patients' functioning increased, their quality of life improved and they perceived much less pain. It may be that improvement in fibromyalgia may depend upon factors such as increased endurance and more effective coping skills rather than upon changes in tender point and generalized pain severity."

When tested six months following the program, treatment gains were not maintained. The authors suggest the patients did not continue to practice coping skills and the exercise regimen. The authors conclude, "Relapse prevention should be emphasized and efforts made to encourage patients to continue to exercise together and participate in regular support groups."

Mason LW, Goolkasian P, and McCain GA. Evaluation of a multimodal treatment program for fibromyalgia. Journal of Behavioral Medicine 1998;21(2):163-178.